Individual provider Active NPI

Ira Seth Sherrill, PA-C

  • Physician Assistant
  • Crossville, TN
National Provider Identifier
1851034136
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5075 Issued in TN
Practice address
100 Lantana Rd Ste 202
Crossville, TN 38555-1903
Phone
(931) 252-1331
NPI assigned
Apr 15, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5075 TN Primary

Addresses

Primary practice location

100 Lantana Rd Ste 202
Crossville, TN 38555-1903

Mailing address

PO Box 221
Crab Orchard, TN 37723-0221
Phone (931) 252-1331

Other identifiers 1

IdentifierTypeStateIssuer
Q076657MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sherrill.ira.seth@covenanthealth.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220927001523 TN Practitioner - Physician Assistant 9032595129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical Group IncGroup PAC ID 2860305463, 363 clinicians

Practice addresses (Care Compare)

100 Lantana Rd
Suite 202
Crossville, TN 38555-1903
Phone (931) 484-5141

111 Clyde St
Loudon, TN 37774-1600
Phone (865) 458-1554

132 Stonehenge Dr
Crossville, TN 38558-6279
Phone (931) 484-5141

6600 Nightingale LN
Knoxville, TN 37909-2754
Phone (865) 632-5885

Hospital & facility affiliations

  • Cumberland Medical Center Hospital, Crossville, TN, CCN 440009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5075TNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group, Inc. Physician Assistant CurrentSince Aug 1, 2022 Accepting new patients
Covenant Medical Group, Inc CurrentSince Aug 1, 2022 Accepting new patients

Locations

100 Lantana Rd
Ste 202
Crossville, TN 38555
Phone (931) 484-5141

Dept 888179
Knoxville, TN 37995

111 Clyde St
Loudon, TN 37774
Phone (865) 458-1554

Interoperability endpoints

  • Direct secure messaging: sherrill.ira.seth@covenanthealth.cernerdirect.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1649980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1851034136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 221",
            "city": "CRAB ORCHARD",
            "state": "TN",
            "postal_code": "377230221",
            "telephone_number": "931-252-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 LANTANA RD STE 202",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385551903",
            "telephone_number": "931-252-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERRILL",
        "first_name": "IRA",
        "middle_name": "SETH",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-15",
        "last_updated": "2022-08-24",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "5075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q076657",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sherrill.ira.seth@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "100 Lantana Rd Ste 202",
            "city": "Crossville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "385551903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crossville, TN

Sources for this page

Verify at the official NPI Registry.